Unhappiness ou " dépression " alléguée pour
être le
résultat de
l'anomalie biologique s'appelle " biologique " ou "
endogène
" ou
dépression " clinique ". En son livre le
cerveau cassé:
Révolution biologique en psychiatrie,
université
de psychia- de l'Iowa
professeur Nancy Andreasen, M.D., Ph.D. d'essai, dit " la
limite plus ancienne
endogène implique que les `grows de dépression de
dans ' ou
est
biologiquement causé, avec l'implication qui malheureuse
et
des événements douloureux tels que détruire
un travail ou
un amoureux ne peuvent pas être
considérés
le contribution cause " (Harper et Row, 1984, p. 203).
De même, dedans
1984 dans le bac de teinture de Joan de
chroniqueur de journal de Chicago Tribune
allégué: " les désordres dépressifs
sont
fondamentalement biochimiques - et
non causé par des événements ou des
circonstances
environnementales ou personnel
rapports " (juillet 30, 1984, sec 1, p. 16).
Le concept de la
dépression biologique ou endogène est important
à la psychiatrie pour deux raisons. D'abord, elle
est la plus commune
maladie mentale supposée. Comme le vainqueur I.
Reus, M.D., a écrit en 1988:
" l'histoire du diagnostic et du traitement du melancholia
pourrait
servez d'histoire de la psychiatrie elle-même "
(apparaissant dans: H. H.
Goldman, éditeur, examen de la psychiatrie
générale, 2ème édition,
Appleton
et Lange, 1988, p. 332). En second lieu, tous les "
traitements " biologiques de la psychiatrie
pour la dépression - si c'est des drogues, electroshock,
ou
le psychosurgery - sont basés sur l'idée cette
l'unhappiness nous
la dépression d'appel peut être provoquée par
un défaut
de fonctionnement biologique plutôt
que l'expérience de la vie. La croyance incorrecte
dans biologique
la causation justifie l'utilisation autrement injustifiable
de biologique
thérapies. Et les thérapies biologiques
justifient l'existence de
psychiatrie comme spécialité médicale
distinguable de la
psychologie
ou consultation.
Beaucoup de le
professionnel et les personnes étendues pensent
aujourd'hui la
dépression
peut être provoqué par " déséquilibre
chimique " dans le
cerveau quoique
aucune des théories " de déséquilibre
chimique " de
dépression n'a été
vérifié. Certains d'entre elle sont
discutés par
Dr. Andreasen dans elle
réservez le cerveau cassé.
Un des théories
qu'elle décrit est la croyance cela
" dépression " (ce que je pense devrais s'appeler
simplement
l'unhappiness ou
l'unhappiness grave) est le résultat des anomalies de
neuroendocrine
indiqué par le cortisol excessif dans le sang.
L'essai pour ceci
s'appelle l'essai de dexamethasone-suppression ou le DST.
La théorie
derrière cet essai et les réclamations de son
utilité ont
été trouvés à
soyez confondu, cependant, parce que, dans des mots de Dr.
Andreasen, " tellement beaucoup
les patients présentant la maladie dépressive bien
définie
ont DSTs normal "
(pp 180-182). Un article dans l'école
médicale de juillet 1984 Harvard
La lettre de santé a tiré une conclusion
semblable. L'article, intitulé
" Diagnostiquant La Dépression: Comment bon est le `DST
'?
", enregistré cela
" pour des patients de chaque trois bureaux avec un DST
anormal, seulement un
est susceptible d'avoir la dépression vraie... [ et ] une
grande fraction de
les gens qui sont enfoncés par d'autres critères
immobile
auront la normale
résultats sur le DST " (p. 5). De même, dans
un
article dans
Archives de novembre 1983 des médecins internes de
la médecine trois
conclu que les " données des études actuellement
disponibles pas
supportez l'utilisation de la rue de dexamethasone [ essai de
suppression ] "
(Martin F. Shapiro, M.D., et autres, " polarisations dans le
diagnostic de laboratoire de
Dépression dans la pratique médicale ", le vol.
143, le p.
2085).
En 1993 en son livreS' Il Fonctionne Dans Votre Famille: Dépression,
Connie S. Chan, Ph.D.,
reconnaît que " il ne reste aucun essai biologique valide
pour
dépression " (livres de coq nain, p. 106). Mais en
dépit du son ayant été
critiqués, quelques psychiatres biologiquement
orientés
sont (appar-
ently) si désireux pour des explications biologiques pour
l'unhappi- des personnes
des ness ou " dépression " cette elles continuent à
utiliser le DST de toute façon.
Par exemple, en son livre les bonnes nouvelles au
sujet de la dépression, publication
lished en 1986, marque S. Gold, M.D. de psychiatre, le dit
continue à utiliser le DST. Dans ce Dr. de livre
Gold réclame le DST
est " touted fortement comme test de
diagnostic pour la dépression biologique "
(coq nain, p. 155, emphase dans l'original).
Dans le
cerveau cassé,
Dr. Andreasen décrit également ce qui
elle appelle " la théorie le plus largement reçue
au sujet
de la cause de
dépression... l'hypothèse de `catecholamine. ' "
Elle souligne
ce " l'hypothèse de catécholamine est
théorie plutôt que
fait "
(p. 231). Elle dit que " cette hypothèse
suggère
que des patients
la souffrance de la dépression ont un déficit de
nopépinéphrine dans
cerveau " (p. 183), nopépinéphrine étant une
" du
catéchol principal
systèmes d'amine " dans le cerveau (pp 231-232).
One-way le catéchol
l'hypothèse d'amine est évaluée est en
étudiant un de la
panne
produits de nopépinéphrine, appelés MHPG,
dans l'urine. Les gens avec
la prétendue maladie dépressive " a tendu à
avoir MHPG
inférieur " (p. 234).
Le problème avec cette théorie, selon Dr.
Andreasen, est
celui
" non tous les patients présentant la dépression
ont bas
MHPG " (ibid). Elle
conclut en conséquence que cette hypothèse de
catécholamine " n'a pas
pourtant expliqué le mécanisme causant la
dépression " (p.
184).
Une autre
théorie est cet unhappiness grave
(" dépression ") est provoqué par les niveaux
abaissés ou
l'utilisation anormale de
un autre produit chimique de cerveau, sérotonine.
***
TRANSLATION ENDS HERE ***nbsp;A panel of experts
assembled
by the U.S. Congress Office of Technology Assessment reported
in
1992 that "Prominent hypotheses concerning depression
have
focused on altered function of the group of neurotransmitters
called monoamines (i.e., norepinephrine, epinephrine,
serotonin,
dopamine), particularly norepinephrine (NE) and serotonin.
...
studies of the NE [norepinephrine] autoreceptor in depression
have found no specific evidence of an abnormality to date.
Currently, no clear evidence links abnormal serotonin
receptor
activity in the brain to depression. ... the data
currently
available do not provide consistent evidence either for
altered
neurotransmitter levels or for disruption of normal receptor
activity" (The Biology of Mental Disorders, U.S.
Gov't Printing Office,
1992, pp. 82 & 84).
Even if it was shown there is
some biological change or
abnormality "associated" with depression, the question
would
remain whether this is a cause or an effect of the
"depression".
At least one brain-scan study (using positron emission
tomography
or PET scans) found that simply asking normal people to
imagine
or recall a situation that would make them feel very sad
resulted
in significant changes in blood flow in the brain (Jose V.
Pardo,
M.D., Ph.D., et al., "Neural Correlates of Self-Induced
Dysphoria", American
Journal of Psychiatry, May 1993, p. 713). Other
research will probably
confirm it is emotions that cause biological changes in the
brain
rather than biological changes in the brain causing emotions.
One of the more popular
theories of biologically caused
depression has been hypoglycemia, which is low blood sugar.
In
his book Fighting Depression, published in 1976, Harvey M.
Ross,
M.D., said "In my experience as an orthomolecular
psychiatrist, I
find that many patients who complain of depression have hypo-
glycemia (low blood sugar). ...Because depression is so
common
in those with hypoglycemia, any person who is depressed without
a
clear cut obvious cause for that depression should be
suspected
of having low blood sugar" (Larchmont Books, p. 76 &
93). But in
their book Do You Have A Depressive Illness?, published in
1988,
psychiatrists Donald Klein, M.D., and Paul Wender, M.D., list
hypoglycemia in a section titled "Illnesses That Don't
Cause
Depression" (Plume, p. 61). The idea of hypoglycemia
as a cause of
depression was also rejected in the front page article of the
November 1979 Harvard Medical School Health Letter, titled
"Hypo-
glycemia - Fact or Fiction?".
Another theory of a physical
disease causing psychological
unhappiness or "depression" is hypothyroidism. In
her bookCan Psychotherapists Hurt You? psychologist Judi
Striano, Ph.D., includes a chapter titled "Is It Depression
- Or
An Underactive Thyroid?" (Professional Press, 1988).
Similarly,
three psychiatry professors in 1988 asserted "Frank
hypo-
thyroidism has long been known to cause depression" (Alan I.
Green,
M.D., et al., The New Harvard Guide to Psychiatry, Harvard
Univ. Press,
1988, p. 135). The theory here is that the thyroid gland,
which is
located in the neck, normally secretes hormones which reach
the
brain through the bloodstream necessary for a feeling of
psychological well being and that if the thyroid produces too
little of these hormones, the affected person can start
feeling
unhappy even if no problems result from the endocrine (gland)
problem other than the unhappiness. The American
Medical
Association Encyclopedia of Medicine lists many symptoms
of
hypothyroidism: "muscle weakness, cramps, a slow heart rate,
dry
and flaky skin, hair loss ... there may be weight gain"
(Random
House, 1989, p. 563). The Encyclopedia does not list
unhappiness or
"depression" as one of the consequences of
hypothyroidism. But
suppose you began to experience "muscle weakness,
cramps...dry
and flaky skin, hair loss ... weight gain"? How would
this make
you feel emotionally? - depressed, probably. Just as
hypo-
thyroidism (hypo = low) is a thyroid gland that produces too
little, hyperthyroidism is a thyroid glad that produces too much.
Therefore, if hypothyroidism causes depression, then it
seems
logical to assume hyperthyroidism has the opposite effect,
that
is, that it makes a person happy. But this is not
what happens.
As psychiatrist Mark S. Gold, M.D., points out in his book
The
Good News About Depression: "Depression occurs in
hyperthyroid-
ism, too" (p. 150). What are the consequences of
hyperthy-
roidism?: Dr. Gold lists abundant sweating, fatigue, soft
moist
skin, heart palpitations, frequent bowel movements, muscular
weakness, and protruding eyeballs. So both hypo- and
hyper-
thyroidism cause physical problems in the body. And both
cause
"depression". This is only logical. It is
hard to feel anything
but bad emotionally when your body doesn't feel well or work
properly. It has never been proved hypothyroidism affects
mood
other than through its effect on the victim's experience of
feeling physically unhealthy.
Some people think chemical
imbalance related to
hormonal changes must be a possible cause of
"depression" because
of the supposed biological causes of women's moods at
different
times of their menstrual cycles. I don't find that argument
con-
vincing, because I've known so many women whose mood and state
of
mind was consistently unaffected by her menstrual cycle.
Psychology professor David G. Myers, Ph.D., labels
premenstrual
syndrome (PMS) a myth in his book The Pursuit of Happiness(William Morrow & Co., 1992, pp. 84-85). Of course,
some women
experience physical discomfort due to menstruation.
Feeling
lousy physically is enough to put anybody in a bad mood.
Some people believe women
experience undesirable mood
changes for biological reasons because of menopause.
However, a
study by psychologists at University of Pittsburgh reported
in
1990 found that "Menopause usually doesn't trigger stress
or
depression in healthy women, and it even improves mental
health
for some". According to Rena Wing, one of the
psychologists who
did the study, "Everyone expects menopause to be a
stressful
event, but we didn't find any support for this myth"
("Menopausal
stress may be a myth", USA Today, July 16, 1990, p.
1D).
It is also widely believed
that women go through a
period of depression for biological reasons after giving birth
to
a child. It's called postpartum depression. In his
book The
Making of a Psychiatrist, Dr. David Viscott quotes Dr.
George
Maslow, a physician doing an obstetrical residency, making
the
following remark: "Come on, Viscott, do you really believe
in
postpartum depression? I've seen maybe two in the last
three
years. I think it's a lot of shit you guys [you
psychiatrists]
imagined to drum up business" (Pocket Books, 1972, p. 88).
A woman
who had given birth to eight (8) children, which in my
opinion
qualifies her as an expert on the subject of postpartum
depression, told me what she called "postpartum blues"
are real,
but she attributed postpartum blues to psychological rather
than
physiological causes. "I don't know about the
physiological
causes", she said, but "so much of it is
psychological." She
said "You feel awful about your looks", because in our
society a
woman is "supposed" to be thin, and for at least a
short time
after giving birth a woman just isn't. She also said
after
childbirth a woman feels considerable "physical
exhaustion".
Childbirth also is the beginning of new or increased parental
obligations, which if we are honest we must admit are quite
burdensome. The arrival of new or additional parental
obligations and the realization of the negative ways new or
additional parenthood obligations will affect a woman's (or
man's) life is an obvious non-biological explanation for
postpartum depression. It may not be until the actual birth
of
the child that parents realize how parenthood changes their
lives
for the worse, but a letter from a female friend of mine who
at
the time was only three months pregnant with her first child
illustrates that depression associated with childbirth may
come
long before the postpartum period: She said she was
frequently
breaking down in tears because she thought with a child her
life
would never the same and that she would be a "prisoner"
and
wouldn't have time to do what she wanted in life. A reason
these
psychological causes are often not candidly acknowledged and
postpartum (or pre-partum) blues instead attributed to
unproven
biological causes is our reluctance to admit the downside of
parenthood.
Another theory of biologically
caused depression is
based on stroke damage in the left front region of the brain
causing depression. What makes it seem possible this might
be
neurologically caused rather than being a reaction to the
situation a person finds himself in because of having had a
stroke is stroke damage in the right front of the brain
allegedly
causing "undue cheerfulness." However, a careful
reading of
books and articles about neurology for the most part doesn't
support the allegation of undue cheerfulness from right front
brain damage. Instead, what most neurological
literature
indicates sometimes results from right front stroke-related
brain
damage is anosagnosia, usually described as lack of concern
or
inability to know their own problems, not happiness or cheer-
fulness (e.g., Dr. Oliver Sacks in The Man Who Mistook His
Wife
for a Hat and Other Clinical Tales, Harper & Row, 1985,
p. 5).
Perhaps the most often heard
argument is that
antidepressant drugs wouldn't work if the cause of depression
was
not biological. But antidepressant drugs don't work.
As
psychiatrist Peter Breggin, M.D., said in 1994, "there's
no
evidence that antidepressants are especially effective"
(Talking
Back to Prozac, St. Martin's Press, p. 200). In studies
placebos often
do as well. Even if so-called antidepressants did help,
that
wouldn't prove a biological cause of "depression" any
more than
would feeling better from taking marijuana or cocaine or
drinking
liquor.
A careful reading of the books
and articles by
psychiatrists and psychologists alleging biological causes of
the
severe unhappiness we call depression usually reveals purely
psychological causes that explain it adequately, even when
the
author believes he has given a good example of biologically
caused depression. For example, in Holiday of Darkness:
A
Psychologist's Personal Journey Out of His Depression (John
Wiley &
Sons, 1982), an autobiographical book by York University
psychology professor Norman S. Endler, Ph.D., he alleges his
unhappiness or so-called depression "was biochemically
induced"
(p. xiv). He says "my affective disorder was
primarily
biochemical and physiological" (p. 162). But from his
own words
it's obvious his depression was due primarily to unreturned
love
when a woman he got emotionally involved with, Ann, decided
to
"wind down" her relationship with him (pp. 2-5) and
when he
suffered a career setback (loss of a research grant) at about
the
same time (p. 23). Despite his claims of biochemical
causation,
nowhere does he cite any medical or biological tests showing
he
had any kind of biological, biochemical, or neurological
abnormalities. He can't, because no valid biological test
exists
that tests for the presence of any so-called mental illness,
including allegedly biologically caused unhappiness (or
"depression"). Similarly, in The Broken
Brain, psychiatry
professor Nancy Andreasen gives the example of Bill, a
pediatrician, whose recurrent depression she thinks
illustrates
that "People who suffer from mental illness suffer from a
sick or
broken brain [emphasis Andreasen's], not from weak will,
laziness, bad character, or bad upbringing" (p. 8).
But she seems
to overlook the fact that Bill's allegedly biologically
caused
recurrent depressions occurred when his father died, when he
was
not permitted to graduate from medical school on schedule,
when
his first wife was diagnosed with cancer and died, when his
second wife was unfaithful to him, when he was arrested for
public intoxication during an argument with her and this was
reported in the local newspaper, and when his license to
practice
medicine was suspended because of stigma from psychiatric
"treat-
ment" he received (pp. 2-7).
One of the reasons for
theorizing about biological
causes of severe unhappiness or "depression" is
sometimes people
are unhappy for reasons that aren't apparent, even to them.
The
reason this happens is what psychoanalysts call the
unconscious:
"Freud's investigations shocked the Western world ...
Comparing
the mind to an iceberg, largely submerged and invisible, he
told
us that the greater part of the mind is irrational and uncon-
scious, with only the tip of the preconscious and conscious
showing above the surface. He maintained that the
larger,
unconscious part - much of it sexual - is more important in
guiding our lives than the rational part, even though we
deceive
ourselves into believing it is the other way around" (Ladas,
et
al., The G Spot And Other Recent Discoveries About Human
Sexuality, Holt,
Rinehart & Winston, 1982, pp. 6-7). In An Elementary
Textbook of
Psychoanalysis, Charles Brenner, M.D., says "the
majority of
mental functioning goes on without consciousness... We
believe
today that...mental operations which are decisive in
determining
the behavior of the individual...even complex and decisive ones
-
may be quite unconscious" (Int'l Univ. Press, 1955, p. 24).
A news
magazine article in 1990 reported that "Scientists
studying
normal rather than impaired subjects are also finding
evidence
that the mind is composed of specialized processors that
operate
below the conscious level. ...Freud appears to have been
correct
about the existence of a vast unconscious realm" (U.S.
News & World
Report, October 22, 1990, pp. 60-63). People's
unhappiness or so-
called depression being caused by life experience is not
always
obvious, because the relevant mental processes and memories
are
often hidden in the unconscious parts of their minds.
I believe unhappiness or
so-called depression is alwaysthe result of life experience. There is no convincing
evidence
unhappiness or "depression" is ever biologically
caused. The
brain is part of our biology, but there is no evidence severe
unhappiness or "depression" is sometimes biologically
caused any
more than bad TV programs are sometimes electronically caused.
"[T]he question is not how to get cured, but how to
live" (Joseph
Conrad, quoted by Thomas Szasz, The Myth of Psychotherapy,
Syracuse
Univ. Press, 1988, title page). "When mental health
professionals point to
spurious genetic and biochemical causes," of depression
and
recommend drugs rather than learning better ways of living,
"they
encourage psychological helplessness and discourage personal
and
social growth" of the sort needed to really avoid
unhappiness or
"depression" and live a meaningful and happy life
(Peter Breggin,
M.D., "Talking Back to Prozac" Psychology Today
magazine, July/
Aug 1994, p. 72).

THE AUTHOR, Lawrence Stevens, is a lawyer whose practice has
included representing psychiatric "patients". His
pamphlets are
not copyrighted. Feel free to make copies.